胃黏膜病变根除幽门螺杆菌后转归的研究

目的探讨清除幽门螺杆菌后对胃黏膜病变转归的影响。方法人选患者均经胃镜和临床病理诊断为慢性胃炎、萎缩性胃炎伴肠上皮化生,并确定有Hp感染的状态。患者分两组：幽门螺杆菌根治组慢性胃炎42例、萎缩性胃炎伴肠上皮化生45例,未行Hp治疗组慢性胃炎41例、萎缩伴肠上皮化生38例;于根除幽门螺杆菌后1年行胃镜随访,在同一部位取活检,根据病理结果的不同分为好转和无好转。结果治疗Hp1年后慢性胃炎根治组逆转率54．52％（23／42）,未根治组19．51％（8／41）,组间比较有非常明显差异（χ^2=11．06,P〈0．01）;Hp根治组萎缩性胃炎伴肠上皮化生病变逆转率15．56％（7,45）,未根治组10．53％（4／38）,组间比较无明显差异。结论根除Hp1年后慢性胃炎病变有明显好转,对萎缩性胃炎伴肠上皮化生病变无明显影响。     

幽门螺杆菌感染及胃炎类型与反流性食管炎关系的研究

目的研究幽门螺杆菌(Hp)感染对胃炎类型及食管酸暴露的影响,特别是 Hp 的定植密度与反流性食管炎(RE)的关系,进一步探讨 Hp 在反流性食管炎(RE)发病中的作用。方法具有典型反酸、烧心等症状的223例胃食管反流病患者,经胃镜检查并取胃黏膜活检进行病理学检查、胃食管24h pH 监测。根据胃镜下食管黏膜有无糜烂诊断 RE 或非糜烂性反流病(NERD),结合胃镜及病理,将胃炎分为4组:慢性非萎缩性胃窦炎组(CNAA 组,胃窦慢性非萎缩炎症为主,胃体部黏膜基本正常);慢性非萎缩胃炎组(CNAG 组,胃窦、体均有明显慢性非萎缩性炎症);慢性萎缩性胃窦炎组(CAA 组,慢性胃窦萎缩性炎症);慢性萎缩性胃炎组(CAG 组,慢性胃窦、体部多灶性萎缩性炎症)。WS 染色诊断 Hp 感染状态,并根据 Hp 定植密度分为轻、中、重度感染。24h pH 监测以DeMeester 积分≥15为阳性诊断标准。结果 223例 GERD 患者中62例(27.8％)胃镜证实为 RE,余161例(72.2％)为 NERD。Hp 阳性者67例(30.0％),Hp 阳性及 Hp 阴性患者之间的年龄、性别、RE发生率、pH 监测阳性率、DeMeester 积分等比较差异无统计学意义;223例患者中 CNAA 45例(20.2％),CNAG 88例(39.5％),CAA 65例(29.2％),CAG 25例(11.2％)。Hp 阳性患者表现为明显的胃窦、胃体部非萎缩性慢性炎症(56.7％),与 Hp 阴性组患者胃炎的构成比显著不同(P<0.05);RE 组 CAG 所占比例低于 NERD 组(6.5％比13％);67例 Hp 阳性的 GERD 患者中,胃体部中重度感染组的24h pH 监测阳性率及胃内平均 pH 值与轻度感染组比较差异有统计学意义(46.4％比73.5％和2.3±0.8比2.0±1.1,P<0.05)。结论 Hp 感染对胃炎的类型和部位有明显的影响;Hp 感染的部位和程度对胃内酸度及食管酸暴露的程度亦有显著影响;弥漫性萎缩性胃炎可能对 RE的发生有一定的保护作用。     

Possible role of Helicobacter pylori serology in reducing endoscopy workload.

We validated a commercial enzyme-linked immunosorbent assay (ELISA), Helico-G, in diagnosing H. pylori in 129 patients (mean age 50 years, range 15-86). We analysed the results of endoscopy against serology to see whether there was a possibility of adopting the strategy of not endoscoping dyspeptic subjects under the age of 45. H. pylori infection was considered present if either histology and/or culture were positive. The ELISA had a sensitivity of 88%, specificity of 72%, positive predictive value of 85%, negative predictive value of 77% and accuracy of 82% in detecting H. pylori. In a subgroup of 52 subjects aged 45 or less (mean age 35 years, range 15-45), 17 out of 25 patients with positive endoscopic findings were H. pylori seropositive while 16 out of 27 patients had normal endoscopic findings. Eighteen out of the 52 patients (35%) were H. pylori seronegative and normal endoscopically except for five patients (10%) who had mild to moderate oesophagitis and two who had non-erosive gastritis (4%). All patients with duodenal ulcer disease (7) were seropositive giving predictive values of positive and negative serology for a diagnosis of duodenal ulcer disease as 28% and 100%, respectively. Therefore adopting a strategy of endoscoping subjects under the age of 45 only if they were H. pylori seropositive would have saved 35% of endoscopies in this age group but missed oesophagitis in 10%. Negative serology would tend to exclude duodenal ulcer disease while positive serology discriminates poorly for it. Serology may be a useful adjunct in screening to reduce endoscopy workload provided that patients with gastro-oesophageal reflux symptoms are excluded.     

反流性食管炎与幽门螺杆菌感染的相关性调查

目的　探讨反流性食管炎与幽门螺杆菌 (Hp)感染的相关性。 方法　对 71例内镜诊断的反流性食管炎患者行快速尿素酶检测和病理学检查 (Giemsa染色 )以检测Hp ,并与慢性胃炎伴胆汁反流 5 0例及十二指肠溃疡 5 4例进行比较。结果　反流性食管炎组与慢性胃炎伴胆汁反流组的Hp检出率均较低 ,两组间差异无显著性 ,但与十二指肠溃疡组Hp检出率的差异有显著性 (P <0 .0 5 )。各级反流性食管炎Hp检出率的差异无显著性 (P >0 .0 5 ) ;反流性食管炎组中 ,年龄≥ 6 5岁者的Hp检出率明显高于年龄 <6 5岁者 (P <0 .0 1)。 结论　反流性食管炎与慢性胃炎伴胆汁反流患者中的Hp感染率较低 ,Hp感染与反流性食管炎分级无相关性 ,但随年龄增长 ,Hp感染率呈增高趋势     

幽门螺杆菌感染在残胃黏膜病变中作用的临床观察

目的:通过检测残胃黏膜幽门螺杆菌(Hp)感染,探讨Hp与残胃黏膜病变的关系.方法:对45例胃大部切除的残胃进行胃镜、病理检查和Hp检测,以同期非残胃患者为对照组,进行以上三项的比较.结果:①残胃组和对照组Hp检出率分别为22.2%和60%(P＜0.05).②存在胆汁反流和非胆汁反流患者Hp检出率分别为17.2%和43.8%.(P＜0.05)③胆汁反流发生率,毕罗Ⅱ式手术明显多于毕罗Ⅰ式,分别为46.6%和17.7%(P＜0.05).④残胃黏膜病理,Hp感染和非Hp感染患者有中-重度胃黏膜病变并有异型增生分别为66.7%和21.2%(P＜0.05).对有Hp感染的对照组和残胃组的病理改变无显著差别(p>0.05).结论:Hp感染是残胃炎发生的重要原因.根除Hp有临床意义.毕罗Ⅱ式较毕罗Ⅰ式手术胆汁反流发生高:而伴有胆汁反流者Hp感染率较低.应该综合治疗.     

胆汁反流性胃炎126例胃镜分析

目的探讨胆汁反流性胃炎的胃镜下表现与幽门螺杆菌(H.pylori)感染及胃黏膜组织学改变的关系。方法分析研究了6375例次胃镜资料,对胆汁反流性胃炎检出患者观察胃底黏液湖、胃窦黏膜及幽门的开放情况;H.pylori-cagA-IgG抗体测定,快速尿酶试验以及14C呼气试验,3项中有2项阳性者为H.pylori感染;组织学检查按新悉尼标准观察幽门螺杆菌、慢性炎症、活动性、萎缩、肠化等形态学特征,将其严重程度分为无、轻、中、重4级;数据均采用x±s表示,同级阳性率之间比较用χ2检验。结果胆汁反流性胃炎的幽门螺杆菌感染率为46.7%,胆汁反流性胃炎检出患者镜下均发生了胃窦的炎性病变。80%的胆汁反流性胃炎患者存在幽门功能不全。在H.pylori阳性与阴性组之间的镜下改变差异无统计学意义(P>0.05);在组织学方面:浅表性胃炎108例,萎缩性胃炎9例,慢性炎症伴肠化9例。H.pylori阳性组与阴性组之间在组织学方面差异无统计学意义(P>0.05)。结论胆汁反流性胃炎是由于胃、十二指肠运动功能紊乱导致幽门功能失调所致,它与H.pylori的感染无关。     

反流性食管炎与幽门螺杆菌的相关性研究

目的 研究反流性食管炎(RE)与幽门螺杆菌(H.pylori)感染的相关性。方法 检测RE、正常对照、慢性胃炎和十二指肠溃疡组及各级RE患者的H.pylori感染率。选取40例内镜分级B或C级的RE患者，H.pylori阳性及阴性各20例，雷贝拉唑治疗4周后内镜复查，比较治疗效果。结果 RE组、正常组、慢性胃炎组、十二指肠溃疡组的H.pylori感染率分别为30．4％、28．8％、59．0％、91．5％，RE组感染率显著低于胃炎组和溃疡组，与正常人群无明显差异；各级RE患者的H.pylori感染率无明显差异；RE患者经雷贝拉唑治疗后，H.pylori阳性组与阴性组的病变愈合和症状改善情况无明显差异。结论 RE与H.pylori感染可能无相关性。     

反流性食管炎与幽门螺杆菌的相关性研究

目的 研究反流性食管炎(RE)与幽门螺杆菌(H.pylori)感染的相关性。方法 检测RE、正常对照、慢性胃炎和十二指肠溃疡组及各级RE患者的H.pylori感染率。选取40例内镜分级B或C级的RE患者,H.pylori阳性及阴性各20例,雷贝拉唑治疗4周后内镜复查,比较治疗效果。结果 RE组、正常组、慢性胃炎组、十二指肠溃疡组的H.pylori感染率分别为30.4%、28.8%、59.0%、91.5%,RE组感染率显著低于胃炎组和溃疡组,与正常人群无明显差异;各级RE患者的H.pylori感染率无明显差异;RE患者经雷贝拉唑治疗后,H.pylori阳性组与阴性组的病变愈合和症状改善情况无明显差异。结论 RE与H.pylori感染可能无相关性。     

Helicobacter pylori infection, glandular atrophy, intestinal metaplasia and topography of chronic active gastritis in the Nepalese and Japanese population: The age, gender and endoscopic diagnosis matched study

Background: The incidence and mortality from gastric cancer is high in Japanese but extremely low in Thailand. It is different among Asian countries. The aim of this study is to investigate the difference of peptic ulcer disease, glandular atrophy, intestinal metaplasia and topography of chronic active gastritis between the Nepalese and Japanese population. Materials and methods: Nepalese patients were paired with Japanese patients by age, gender and endoscopic diagnosis in order to compare the prevalence of H. pylori infection (N=309) and the difference of H. pylori related peptic ulcer disease (N=48). Glandular atrophy and intestinal metaplasia scores were also compared between the Nepalese and Japanese population in H. pylori positive cases (N=152) and negative cases (N=145) using paired cases by age, gender and endoscopic diagnosis. Paired H. pylori-positive Nepalese and Japanese population were also used to compare the ratio of corpus gastritis to antrum gastritis (C/A ratio) (N=152). Results: Among peptic ulcer diseases, gastric ulcer was frequent in Japanese and duodenal ulcer was frequent in Nepalese. The prevalence of H. pylori infection in the Nepalese and Japanese population were similar. Glandular atrophy and intestinal metaplasia scores in the H. pylori positive Japanese were significantly higher than those of Nepalese in all positions according to triple site biopsy. Furthermore, there were significant differences in glandular atrophy and intestinal metaplasia scores between in the H. pylori-negative Nepalese and Japanese population except intestinal metaplasia score in the greater curvature of the upper corpus. Japanese C/A ratio was significantly higher than that of Nepalese. Corpus predominant gastritis (C/A ratio>1.00) was characteristic in the elderly Japanese. Nepalese was antrum predominant (C/A ratio<1.00) in every age group. Conclusions. Gastric ulcer was a common disease in Japanese, in contrast duodenal ulcer was common in Nepalese. H. pylori infected Japanese patients showed severe atrophic and metaplastic gastritis in comparison with Nepalese. These results may be associated with the high incidence of gastric cancer in Japanese. Corpus predominant gastritis was found in the elderly Japanese and antrum predominant gastritis was found in every age Nepalese. Key words: H. pylori, atrophy, metaplasia, corpus-predominant gastritis, Nepal.     

幽门螺杆菌感染者胃粘膜癌前病变与cmet 原癌基因蛋白表达的关系

目的研究幽门螺杆菌（Ｈｐ）感染后胃粘膜癌前病变中ｃ－ｍｅｔ原癌基因蛋白表达的情况,了解Ｈｐ在胃癌发生过程中的作用。方法１１０例经病理证实为慢性胃炎的病人用免疫组织化学方法检测胃粘膜细胞中ｃ－ｍｅｔ原癌基因蛋白表达。结果在浅表性胃炎、萎缩性胃炎、肠化生及异型增生中,ｃ－ｍｅｔ原癌基因蛋白的表达率分别为２２．２％、４４．１％、６７．５％、６１．９％。过量表达率分别为５．５％、２６．４％、３７．８％、３８．１％。Ｈｐ感染者ｃ－ｍｅｔ原癌基因蛋白表达率明显较未感染者高,分别为６３％及３２％。在萎缩、肠化生及异型增生等癌前病变中,Ｈｐ感染者与未感染者表达率分别为６８．９％及３０．５％（Ｐ＜０．０５）。结论随着病变的进展,ｃ－ｍｅｔ原癌基因的表达随之增加,Ｈｐ感染对ｃ－ｍｅｔ原癌基因蛋白表达有一定的影响。     

幽门螺杆菌感染与儿童及成人胃炎的病理比较分析

目的　比较儿童与成人胃炎的组织病理学特点 ,进一步阐述幽门螺杆菌 (Hp)感染与胃炎的关系。方法　对 1998～ 2 0 0 0年我院 5 0 0例 3～ 15岁儿童及 4 6 2例成人的胃镜活检组织 ,按Sydney胃炎标准进行组织学和Hp观察。 结果　 4 0 .4 %的儿童胃炎、5 0 .9%的成人胃炎与Hp感染有关。Hp阳性的儿童胃炎与Hp阳性的成人胃炎相似 ,幽门腺萎缩、炎症活动性、淋巴滤泡和嗜酸细胞均较Hp阴性胃炎常见。但儿童胃炎很少发生小肠化生 ,这与成人胃炎不同。结论　与成人胃炎一样 ,儿童胃炎活动性与Hp感染关系密切。Hp阳性儿童胃炎的胃黏膜病理变化较非感染者严重 ,常表现为淋巴滤泡形成及中性白细胞浸润。本研究还证实 ,上海属于儿童Hp感染的高发区 ,且儿童胃炎Hp阳性病例的胃黏膜与成人胃炎接近。为减少胃癌及胃溃疡的发生 ,对Hp感染的防治应从儿童抓起     

胆汁返流对慢性胃炎胃黏膜病变的影响

目的探讨胆汁返流对慢性胃炎胃黏膜病变特征的影响。方法采用 2 4h胃腔内胆红素吸光度和pH值联合监测方法 ,检测 4 9例慢性胃炎患者 ,并将其分为胆汁返流阳性组和阴性组。观察胃体、胃角和胃窦黏膜活动性感染等各项病理改变 ,并分析胃内胆汁返流时间与胃黏膜病变特征和胃内pH >4时间之间的相关性。结果 4 9例慢性胃炎患者中 ,38例胃内存在胆汁返流 ,11例不存在胃内胆汁返流。胆汁返流组全胃黏膜病变均较无胆汁返流组严重 ;胆汁返流时间与近端胃黏膜病变呈正相关 ,与pH >4时间无明显相关。结论胆汁返流是慢性胃炎患者全胃黏膜病变的重要病因之一 ,可能会促进H .pylori定植范围向胃体蔓延 ,从而加重近端胃黏膜损伤 ,对胃黏膜酸暴露情况没有显著影响     

根除幽门螺杆菌感染对慢性胃炎的疗效分析

目的探讨慢性胃炎根除Hp患者临床症状、内镜表现及病理变化,明确根除Hp对慢性胃炎的疗效。方法对内镜诊断为慢性胃炎合并Hp阳性患者100例,分为Hp阳性耐药治疗组60例,Hp阳性耐药对照组40例。均以铝碳酸镁片1.0 g口服,3次/日,8周。8周后检测Hp,复查胃镜后评估消化道症状及胃镜改变。结果两组治疗前后症状总评分、内镜下糜烂改变有统计学意义(P<0.05)。Hp阳性耐药治疗组治疗前后症状评分差值为(3.42±1.25),显著高于Hp阳性耐药对照组(2.80±1.24)(P<0.05)。结论伴有Hp感染的慢性胃炎根除Hp有助于症状改善,在耐药患者Hp根除方案的选择上,序贯疗法的根除率优于四联疗法。     

Anemia in children with and without Helicobacter pylori infection

BACKGROUND: Iron deficiency is the most common cause of anemia in children. Recently there has been evidence to suggest a relationship between Helicobacter pylori gastritis and iron deficiency anemia. Because both H. pylori infection and iron-deficiency anemia are common in children, we studied any correlation between H. pylori infection and iron-deficiency anemia in children. METHOD: In a case-control study at the Children's Medical Center Hospital, 100 children with H. pylori infection and 109 children without infection according to histology were evaluated. Iron-deficiency anemia was diagnosed when serum ferritin and hemoglobin levels were less than adjusted values for age and sex. RESULTS: There were 111 boys and 98 girls with a median age of 7.1 years. The main symptom was abdominal pain in H. pylori-infected and non-infected patients. Frequency of H. pylori infection in anemic and non-anemic patients was nearly similar (43.9 and 50.4%, respectively). Among patients with H. pylori, 36% had anemia and in patient without H. pylori infection, its frequency was 42.2% (p = 0.59). Among patients with H. pylori, 19% had iron-deficiency anemia and in patients without H. pylori infection, its frequency was 21.1% (p = 0.7). Among patients with H. pylori, the difference between the severity of gastritis in those with anemia and those without anemia was not statistically significant (p = 0.382) and no correlation was found between degree of H. pylori colonization and anemia. CONCLUSIONS: Our results do not support the proposal that H. pylori infection is associated with iron-deficiency anemia in children. Further studies emphasizing the socioeconomic status of children, evaluation of strains of H. pylori, and posttreatment measurement of serum iron and serum ferritin are necessary to show the possible association.     

幽门螺杆菌与胃及食管反流性疾病关系的研究

目的 探讨幽门螺杆菌与胃及食管反流性疾病之间的关系。方法 对460例具有反流症状的患者进行内镜及组织学检查，并采用免疫印记法检测其血清中的幽门螺杆菌cagA、vacA抗体。结果 反流性食管炎及反流性胃炎患者幽门螺杆菌的最高检出率分别为67．4％和70．2％，反流性食管炎患者cagA、vacA抗体的阳性率分别为56．3％、52. 3％，而反流性胃炎患者cagA、vacA抗体的阳性率为61.9％、60.1％。结论 通过对反流性食管炎及反流性胃炎患者幽门螺杆菌的检测及其抗体的检测，发现幽门螺杆菌感染可能是胃及食管反流性疾病的重要因素。     

血清胃蛋白酶原与幽门螺杆菌相关性胃炎的关系

[目的]探讨血清胃蛋白酶原（serum pepsinogen,sPG）与幽门螺杆菌相关性胃炎的关系。[方法]73例经胃镜及病理确诊为慢性胃炎患者,其中慢性萎缩性胃炎37例,慢性浅表性胃炎36例,对其中49例H.pylori阳性患者均给予丽珠胃三联片剂治疗,治疗前后测血清胃蛋白酶原。[结果]在H.pylori感染病例中,萎缩性胃炎组与浅表性胃炎组PGⅠ值相似,而PGⅡ值萎缩性胃炎明显高于浅表性胃炎组,H.pylori阳性者高于H.pylori阴性者,PGR（PGⅠ/PGⅡ）萎缩性胃炎明显低于浅表性胃炎组,H.pylori阳性者明显低于H.pylori阴性者。经抗H.pylori治疗,87.75%的患者H.pylori被根除,H.pylori已根除的萎缩性胃炎组PGⅠ值上升,PGⅡ值下降,PGR（PGⅠ/PGⅡ）上升,H.pylori未根除的萎缩性胃炎组PGⅠ值,PGⅡ值,PGR（PGⅠ/PGⅡ）无改变,H.pylori已根除的浅表性胃炎组,PGR（PGⅠ/PGⅡ）上升。[结论]H.pylori感染与sPG水平密切相关。血清PGⅠ、PGⅡ及PGR（PGⅠ/PGⅡ）对H.pylori相关萎缩性胃炎的早期诊断有一定应用价值。血清PGR（PGⅠ/PGⅡ）可作为H.pylori根除效果的评价指标。     

Comparison of 4 laboratory methods for detection of Helicobacter pylori

OBJECTIVE: To compare the usefulness of 4 commonly used tests in the diagnosis of Helicobacter pylori H. pylori infection in Saudi patients with dyspepsia. METHODS: Patients presenting with dyspepsia at the gastroenterology clinic of Aseer Central Hospital, Abha, Kingdom of Saudi Arabia between October 2005 to May 2006, who consented to participate in the study were enrolled. Patients who received anti-Helicobacter treatment or proton pump inhibitors within 30 days, or in whom endoscopy revealed cancer or gastro-esophageal reflux, were excluded from the study. Stool sample for H. pylori stool antigen HpSA were tested using the enzyme immunoassay technique 2-7 days before endoscopy. At endoscopy, gastric antrum mucosal biopsies were taken for campylobacter-like organism CLO test, histology and culture. RESULTS: There were 72 males and 43 females, age range from 18-75 years, mean age 40.09+/-15.68. Seventy-nine patients out of the 115 68.7% samples were positive for H. pylori, by culture. Culture and histology agreed in 112 cases 97.4% and disagreed in 3 cases 2.6%. The sensitivities and specificities % of histology were 97.5 and 97.2, of HpSAg were 91.9 and 98.6, and of CLO were 79.7 and 97.2 tests against culture. CONCLUSION: Culture, histology, and H. pylori stool antigen tests all have comparable results, and there is no need to use all 3 at the same time, for the diagnosis of H. pylori infection. The CLO test is less sensitive, and of low negative predictive value.     

幽门螺杆菌阳性的十二指肠溃疡病人胃窦炎症程度和炎症因子的 …

目的 研究幽门螺杆菌（ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ）致十二指肠溃疡时胃窦炎症和炎症因子的作用。方法 选择４８例有不同程度Ｈｐ感染的十二指肠溃疡病人,用组织学方法评定胃窦炎症程度,同时测定胃粘膜内白细胞介素６（ＩＬ－６）白细胞介素８（ＩＬ－８）肿瘤坏死因子α（ＴＮＦα）过氧化物酶（ＭＰＯ）和丙二醛（ＭＤＡ）的含量,结果 ＩＬ－８,ＴＮＦα,ＭＰＯ,ＭＤＡ的含量均与胃窦粘膜的炎症程度和Ｈ     

1586例原发性胆汁反流性胃炎临床病理分析

目的探讨原发性胆汁反流性胃炎(bile reflux gastritis,BRG)的临床特点。方法对胃镜检查确诊的1 586例原发性BRG和随机按年龄组筛选的725例单纯慢性胃炎(si mple chronic gastritis,SCG)的患者进行幽门螺杆菌(H.pylori)检测。对组中部分患者行腹部B超检查观察胆囊病变,并行胃黏膜活组织病理检查。结果原发性BRG的检出率随着年龄升高而下降,原发性BRG中单纯胆汁反流性胃炎967例(61.0%);合并消化性溃疡399例(25.2%);BRG组中合并食道炎或Barrett食管者220例(13.9%),高于SCG组(4.1%))。BRG组中胆囊疾患、肠化、萎缩及不典型增生的检出率均高于SCG组(P<0.05)。BRG组中H.pylori感染率为38.9%,低于SCG组中(52.1%),差异有统计学意义(χ2=35.27,P<0.05)。结论 BRG的检出率随着年龄升高而下降;BRG患者多合并有消化性溃疡、食道疾患及胆囊疾患;BRG的Hpylori感染率明显低于SCG。     

Helicobacter pylori and gastro-oesophageal reflux disease — A prospective study

In a prospective evaluation of the relationship between Helicobacter pylori infection and gastrooesophageal reflux disease (GORD), 93 consecutive patients (47 female: 46 male: mean age, 46 years: range 13-93) with symptoms and endoscopic evidence of GORD were studied. A total of 50 patients (54%) wereH. pylori-positive on gastric antral biopsies. No significant correlation was detected betweenH. pylori status and grade of oesophagitis. The prevalence ofH. pylori infection showed a gradual increase with age. Of 64 patients with a hiatal hernia, 28 (44%) had histological evidence of H. pylori infection of the hernia mucosa; 27 of these patients (96%) had associatedH. pylori in the gastric antrum. Of the 36 patients whose hiatal hernia wasH. pylori-negative, only 6 (17%) had antralH. pylori (P<0.001). Of the 8 patients found to have Barrett’s oesophagus, only 1 hadH. pylori detected on the Barrett’s mucosa. Our results do not support the presence of a significant association betweenH. pylori infection and GORD.